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ILECTRICAL PERMIT AlFw_ICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 1 FAX 425-257-8857 1 (E)everetteps©everettwa.gov 1 www.everettwa.gov/permits <br /> • 2 '1: <br /> PROJECT ADDRESS: LA) -4=zitti— <br /> BUILDING AREA(if residential,new construction,remodel,or addition) SF <br /> BUILDING TYPE: El SFR-DETACHED ID SFR-ATTACHED g DUPLEX 0 MULTI-FAMILY-#OF UNITS: 0 COMMERCIAL <br /> USE OF BUILDING: i2 <br /> ••"- '• • '` ' • •••, <br /> CONTRACT PRICE OF WORK:$ ‘tt <br /> NUMBER OF DEVICES(If low voltage): <br /> FIRE ALARM? 0 YES ' NO <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> DESCRIPTION OF WORK: (2.0..—)tv --r2> A-4, t--ITT— D <br /> A <br /> , . . <br /> - •- - - * •-• - •• -" <br /> OWNER NAME: ---1.--Tz4ES41LZ . TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTasEr 7.--1-1 61 <br /> CRY ^.,"" STATE: Les..14 ZIP <br /> OWNER PHONE: OWNER EMAIL <br /> CONTRACTOR NAME: F4=7:P. <br /> CONTRACTOR ADDRESS: sTREET --p4) "f5tx Oe3 <br /> CITY !)ZcrSTA1E ZIP 47Y64 I <br /> CONTRACTOR PHONE:d'IU`" 6 CONTRACTOR EMAIL: DArg-g-e...--0.1 <br /> CONTRACTOR LIC.#(REQUIRED):—F.t> 8,/,175— CITY OF EVERETT BUSINESS LIC.#(REQUIRED):-5-44 <br /> PRIMARY CONTACT: CI OWNER .CONTRACTOR El OTHER(Please Specify) • <br /> CONTACT NAME: CONTACT PHONE: 4--2„„g-,_ %"'"1 10 <br /> CONTACT EMAIL: ID k3c-r. <br /> AGREEMENT Thereby certify that I have read and examined this application and know the same to be true and correct All provisions of laws and ordinances governing This <br /> type of work will be completed whether specified herein or not The granting of a permit does not presume to give authority o violate ci cancel the provisions of any other state or <br /> local law regulating construction or the performance of construction. That lain authorized by Me owner of this property to peril=the forwhich application is made Erld <br /> l <br /> comply with the State Contractors Law 18.27 RCWand 296.200 WAC. <br /> City of Everett Official Use Only <br /> FEE <br /> PERMIT# <br /> E ii-.116 <br /> Owner •me-Age Signature Date (Revised 10/12/2015) <br />